Active NPI
John Petty, MD
- Physical Medicine & Rehabilitation Physician
- Kettering, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 35038579
- Practice address
- 3535 Southern Blvd
Kettering, OH 45429-1221 - Phone
- (937) 395-8666
- NPI assigned
- May 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 35038579 | OH | Primary |
Addresses
Primary practice location
3535 Southern Blvd
Kettering, OH 45429-1221
Mailing address
PO Box 750245
Dayton, OH 45475-0245
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0525640 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Ohio State University College of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 435-9402
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35038579 | OH | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kettering Physiatrists, Inc. | Physical Medicine & Rehabilitation | Current | Accepting new patients |
Locations
3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221
4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791
630 W Main St
Ste 301
Wilmington, OH 45177
Phone (937) 382-8580
630 W Main St
Wilmington, OH 45177
Phone (513) 475-8520
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Kettering, OH
- NPI 1902893035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1083665343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 750245",
"city": "DAYTON",
"state": "OH",
"postal_code": "454750245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 SOUTHERN BLVD",
"city": "KETTERING",
"state": "OH",
"postal_code": "454291221",
"telephone_number": "937-395-8666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTY",
"first_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OH",
"license": "35038579",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0525640",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.